Calcium Gluconate 10%

Question 1

Drug Class of Calcium Gluconate 10%

Answer 1

Electrolyte

Question 2

Presentation of Calcium Gluconate 10%

Answer 2

• Ampoule, ≈ 1 g/10 mL calcium gluconate 10%

Question 3

Schedule of Calcium Gluconate 10%

Answer 3

• Unscheduled.

Question 4

Pharmacology of Calcium Gluconate 10%

Answer 4

Calcium plays an integral role in the muscular and neural systems. 
It is involved in skeletal muscle contraction, excitation coupling in 
 cardiac and smooth muscle and acts as an intracellular 2nd messenger. These effects combine to exert a positive inotropic effect in the post cardiac arrest patient. It additionally has a role in cardiac membrane stabilisation in hyperkalaemia and as an effective treatment of pain 
 and systemic symptoms associated with hydroflouric acid exposure.

Question 5

Metabolism of Calcium Gluconate 10%

Answer 5

Most of the parenterally administered calcium filtered by the renal glomeruli is reabsorbed; the remained is excreted in faeces.

Question 6

Indications of Calcium Gluconate 10%

Answer 6

• Suspected hyperkalaemic cardiac arrest
• Severe hyperkalaemia (with haemodynamic compromise AND/OR significant cardiac 
 rhythm disturbance)
• Calcium channel blocker toxicity
• Hypotension associated with a 

magnesium infusion (that fails to respond to
 IV fluid therapy)
• Hydrofluoric acid inhalation

Question 7

Contraindications of Calcium Gluconate 10%

Answer 7

• KSAR or hypersensitivity to calcium gluconate

* Digoxin (digitalis) overdose

Question 8

Precautions of Calcium Gluconate 10%

Answer 8

• Respiratory acidosis

Question 9

Side Effects of Calcium Gluconate 10%

Answer 9

• Suspected hyperkalaemic cardiac arrest:
- nil
• For all other QAS indications, IV administration 
 may cause:
- syncope
- hypotension
- bradycardia
- cardiac dysrrhythmias
- cardiac arrest

Question 10

Routes of Administration for Calcium Gluconate 10%

Answer 10

Nebuliser (NEB)
Intravenous injection (IV)
Intraosseous injection (IO)

Question 11

Onset Time of Calcium Gluconate 10% IV

Answer 11

1–3 minutes

Question 12

Duration Time of Calcium Gluconate 10% IV

Answer 12

30–60 minutes (in hyperkalaemia)

Question 13

Half life of Calcium Gluconate 10%

Answer 13

Not applicable

Question 14

Special Notes of Calcium Gluconate 10%

Answer 14

• All cannulae and IV lines must be flushed thoroughly 
 with sodium chloride 0.9% following each medication 
 administration.
• All parenteral medications must be prepared in an aseptic manner. The rubber stopper of all vials must be disinfected with a 3MTM Solu-IVTM swab and allowed to dry prior to piercing.

Question 15

Adult Dose of Calcium Gluconate 10% IV
• Suspected hyperkalaemic cardiac arrest
• Severe hyperkalaemia (with haemodynamic compromise 

Adult dosages AND/OR significant cardiac rhythm disturbance)
• Calcium channel blocker toxicity
• Hypotension associated with a magnesium infusion 
 administration (that fails to respond to IV fluid therapy)

Answer 15

10 mL (≈ 1 g)
Slow push over 2–5 minutes.
Repeated once at 10 minutes.

Question 16

Adult Dose of Calcium Gluconate 10% IO
• Suspected hyperkalaemic cardiac arrest
• Severe hyperkalaemia (with haemodynamic compromise 

Adult dosages AND/OR significant cardiac rhythm disturbance)
• Calcium channel blocker toxicity
• Hypotension associated with a magnesium infusion 
 administration (that fails to respond to IV fluid therapy)

Answer 16

10 mL (≈ 1 g)
Slow push over 2–5 minutes.
Repeated once at 10 minutes.

Question 17

Adult Dose of Calcium Gluconate 10% Neb

Hydrofluoric acid inhalation

Answer 17

2 mL (≈ 0.2 g) of 2.5% concentration
 (0.5 mL calcium gluconate 10% with 
 1.5 mL sodium chloride).
Repeated PRN.

No maximum dose.
Nebuliser solution preparation: Mix 2.5 mL of calcium gluconate 10% with 7.5 mL of sodium chloride 0.9% in a 10 mL syringe to achieve a final concentration of calcium gluconate 2.5%. 
 Ensure all syringes are appropriately labelled.

Question 18

Paediatric Dose of Calcium Gluconate 10% IV
• Suspected hyperkalaemic cardiac arrest
• Severe hyperkalaemia (with haemodynamic compromise 

Adult dosages AND/OR significant cardiac rhythm disturbance)
• Calcium channel blocker toxicity
• Hypotension associated with a magnesium infusion 
 administration (that fails to respond to IV fluid therapy)

Answer 18

0.5 mL/kg (≈ 50 mg/kg)
Slow push over 2–5 minutes.
Repeated once at 10 minutes.

Question 19

Paediatric Dose of Calcium Gluconate 10% IO
• Suspected hyperkalaemic cardiac arrest
• Severe hyperkalaemia (with haemodynamic compromise 

Adult dosages AND/OR significant cardiac rhythm disturbance)
• Calcium channel blocker toxicity
• Hypotension associated with a magnesium infusion 
 administration (that fails to respond to IV fluid therapy)

Answer 19

0.5 mL/kg (≈ 50 mg/kg)
Slow push over 2–5 minutes.
Repeated once at 10 minutes.